Ming Shen Dai

Non-Hodgkin's Lymphoma of the Stomach: Treatment Outcomes for 57 Patients Over a 20-Year Period

Background: Gastric non‐Hodgkins lymphoma (NHL) is a rare subtype of malignancy, for which no consensus exists about treatment. In this study, the treatment outcomes of gastric NHL in 57 patients were retrospectively evaluated for a period of 20 years at a single institute. Methods: Clinical stages were classified according to the Ann Arbor staging system: 29 patients were stage I, 17 stage II, two stage III, and nine stage IV. The 46 stage I/II patients received aggressive, multimodal therapy: 24 of these (group A) were treated with surgery‐based management, which included surgery alone (n = 6), surgery + chemotherapy (CT; n = 14), surgery + radiotherapy (RT; n = 2), and surgery + CT + RT (n = 2); 22 patients (group B) did not receive surgery, but received CT alone (n = 11), CT + RT (n = 5), or, in patients with low‐grade mucosa‐associated lymphoid tissue (MALT) lymphoma, an oral anti‐Helicobacter pylori regimen (n = 6). The 11 stage III/IV patients received CT and/or RT with regimens similar to those for stage I/II patients. Results: Except for 1 patient with an initial surgical diagnosis, 56 patients underwent gastric endoscopic examination, which proved that 42 had NHL. The rate of diagnostic accuracy by gastroscopy was 75%. After multimodal treatment (n = 46) and a median follow‐up of 54 months (range, 1–210 months), the 5‐year survival rate was 40.3%. The 5‐year survival rates for stage I, II and III/IV patients were 57.2%, 47% and 0%, respectively (p < 0.005). Of the 24 surgical patients (group A) who received sequential CT, with or without RT, 12 remained disease‐free after a median follow‐up of 98 months (range, 1–210 months); 3 patients died because of postoperative complications. Of the 22 non‐surgical patients (group B) who received CT, alone or combined with RT, 14 remained disease‐free after a median follow‐up of 40 months (range, 4–189 months); 1 patient died because of massive gastric hemorrhage after CT. All stage III and IV patients died after a median survival of 4 months (range, 1–8 months). Conclusion: Clinical stage is the most important factor predicting the long‐term survival of patients with gastric NHL. Surgery may still be necessary in cases of failed gastroscopic diagnosis. In early‐stage gastric NHL, non‐surgical treatment seems able to achieve the aims of improved long‐term survival and, in some instances, cure.

Improved outcomes in buccal squamous cell carcinoma

The treatment results of buccal squamous cell carcinoma before and after 2002 were compared.

Distinct MR Imaging Features of Triple‐Negative Breast Cancer with Brain Metastasis

Patients with triple‐negative breast cancer (TNBC) are at increased risk of brain metastases (BMs). In this retrospective single‐institutional study, we assessed the radiographic features from a cohort of breast cancer (BC) patients with confirmed BM.

Lapatinib and platinum-based chemotherapy ameliorate breast cancer with choroidal metastasis and restore visual acuity.

Involvement of the central nervous system in metastatic breast cancer is a particularly dismal occurrence because of its effects on mortality and quality of life. Development of choroidal metastasis in a breast cancer patient indicates poor prognosis and has become the major life-limiting problem. Various treatment modalities for choroidal metastasis have been applied with different efficacy. Here we describe a patient with HER2-overexpressing breast cancer and limited choroidal metastasis who responded to an HER2 tyrosine kinase inhibitor after failure of radiotherapy and chemotherapy. Her visual acuity was completely and durably restored after the targeted therapy. This case provides a unique treatment experience of breast cancer with choroidal metastasis.

Association of Tartrate-Resistant Acid Phosphatase-Expressed Macrophages and Metastatic Breast Cancer Progression.

AbstractInfiltrating neutrophils, lymphocytes, macrophages, and cytokines constitute a state of chronic inflammation within the tumor microenvironment. Tartrate-resistant acid phosphatase 5a (TRACP5a) protein, a novel product of activated macrophage, is postulated to be a biomarker for systemic inflammatory burden in states of chronic inflammation. We aimed to investigate the clinical significance of TRACP5a expression in tumor-infiltrating macrophages and serum TRACP5a in patients with metastatic breast cancer (BC).We retrospectively analyzed the clinical data from 34 BC patients with confirmed skeletal/visceral metastasis upon or during first-line palliative treatment. Patients were stratified into 3 groups based on the therapeutic responses and follow-up disease course. The association of TRACP5a protein with other inflammatory and cancer biomarkers was assessed among the clinically distinct group of patients. Higher TRACP5a protein was significantly correlated with earlier disease progression and survival (P = 0.0045) in comparison to other inflammatory markers, CRP or IL-6. Patients with higher serum TRACP5a level and shorter survival and treatment refractoriness also had more TRACP+ tumor-infiltrating macrophages.Our data support a hypothesis that serum TRACP5a protein can potentially be a predictive and prognostic marker to evaluate disease progression and therapeutic response in BC patients with bone/visceral metastasis. The associations between overall survival and TRACP expression by macrophages require further prospective investigation.